HomeMy WebLinkAboutPermit Sidewalk 2009-1-2
Status
Iss u ed
CITYOF ~rK11~GFIELD
Building/Combination Permit
PERMIT NO: COM2009-00006
ISSUED: 01/02/2009
APPLIED: 01/02/2009
EXPIRES: 07/02/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 897 65TH PL
ASSESSOR'S PARCEL NO.: 1702341200800
Springfield TYPE OF WORK: Sidewalk
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: 20 feet sidewalk Repair
Owner: SHIELDS TOMMY L
Address: 897 65TH PL
SPRINGFIELD OR 97478
SCANNED
I CONTRACTOR INFORMATION ,I
Contractor Type
General
Contractor
MCKENZIE TAYLOR
License
109867
Expiration Date
11/09/2010
Phone
747-5413
BUILDING INFORMA nON 1
# of Units:
Primary Occupancy Group:
Secondary Occupaucy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Stmcture
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION 1
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
. 'YOU to
, I W requireS 'I't
_". ",pnon a ~__n"n Uti I 'I
AT I t:1"t 1'''''' ted oy l\ I.... - - senDHu
I PUBLIC IMPROVEMENTS 1 'IIOW rules adoP Those rules are 2-00~.
o +"n Genter. hOAR 95
Notlll'Sidewalkfy(!<!:O throUg I the rules by
in OAR 9"'L-~~" hlai(\ copies 0 e\ep\iOne
0090DQwnSPou~~'Pef.alr.~i.lte: the ~otilicatlon
calling the ~he oregon UtI\lti344).
number lor . ~ _600-332-
center IS .
Storm Sewer A"~illrt1l~E'
In:,-rIV .
Special Instruct;oms PERMIT SHALL EXPIRE IF THE WORK
Notes: AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
I-\IH I tiU UAY PI:RIUD.
I ValuationDescriDtion I
Description
Type of Construction
$ rer Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of2
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00006
ISSUED: 01/02/2009
APPLIED: 01/02/2009
EXPIRES: 07/02/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone .
541-726-3676 Fax
541-726-3769. Inspection Line
Total Value of Project
F~,~s Paid 1
Fee Descriotion
+ 5% Technology Fee
Sidewalk Permit
Amount Paid
Date Paid
Receipt Number
$4.40
$88.00
, 1/2109
, 1/2109
!
2200900000000000002
2200900000000000002
Total Amount Paid
$92.40
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
R~o!l,ired In,s?ect,io~\I
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will he made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
J further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times dU~in~~ 01//)2--/0<)
Owner .;;:-co~tr~ctors Signatuje Date
Page 2 of2
225 Fifth Street
Sp;i~grl'eld, Oregon 97477 .
541-726-3759 Phone
Job/Journal Number
COM2009-00006
COM2009-00006
Payments:
Type of Payment
Check
cReedotl
RECEIPT #:
Description
Sidewalk Pennit
+ 5% Technology Fee
Paid By
MCZKENZIE TAYLOR
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000002
Date: 01/02/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Ikw
1035
In Person
Payment Total:
Page I of I
9:08:02AM
Amount Due
88.00
4.40
$92.40
Amount Paid
$92.40
$92.40
1/2/2009
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~,,' ,- ,: .' , . 0." -, LilTJ/O.J;lJpnnlt/I'(,!lU . ,':', _" .~_ ,I'"
',:::,:'::',-'::"~:"<: :<:;~. :~;::,':;:.:.i.;.',:.",,,,<,<,:o:':'<~:~); ;::: "<: ,:-, ::"'~~~',~~;:;.~~}\
"t..~OtDRIVEWAY/SIDEWALK:' ::~:: j':::' PERMIT APPLICATION ::':..:'.,)};
225 FiFtH STREET OPR'N.~"Diiiij
SPRINGFIELD, OREGON 97477 ',h __
ENGINEERING DIVISION
OFFICE TELEPHONE (503) 726-3753 . . ~ ~
APPLICATION DATE: tJ I / D2-/ ci!)
PERMIT NUMBER:
DATE ISSUED
&mz;m;q - IftJ-ottl...
1- .-1-09
SITE INFORMATION:
LOCATION OF WORK, 6iJJl1>IllA'j...y" A-u'fll{; :.rf.{-u~~p ~
APPLICANT M.atj4~:z.i~ /r~U/y;, d>rJ.srPHONE '1'-17 Yil3
ADDRESS 1'('; l' &f)Ol' pr. .
CIW f:,pI!-iAlbRGlOSTATE' tJe-.
SUBDIVISION:
OWNER~~ (AieuJ<
ADDRESS .'t 17 I (p SO'- k
TAX MAP:
ZIP, 0, 71f7~
TAX LOT:
; PHONE:
ZIP:
tl;7119
CITY:
!,PIJ.Wbf;JG-U')
/U_
STATE:
REOUESTED PERMITS:
~ SIDEWALK: ....,...........,....
AMOUNT OF SIDEWALK IN EXCESs .OF 90FT,
$SS,OO
@$OOB SF.
... ............ $15.50
.....,.. =$
=$
...........:..............:=$
o SIDEWALK REPAJR:....
o CURS CUT/ORIVEWAY, NUMBER OF DRIVEWAYS~ X
o MULTIPLE PERMIT DISCOUNT EA: ,.......{MAX 2) .
............ $8S.00 151 CuI = $
..$30.00
2nd CuI =;U'
I
I
(MULTI PERMIT DISCOUNT GOOO FOR ONE SITE AND ONE SITE INSPECTION .DM.X
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIOEWALK REPAIR) =$
o 5% Technology Fee $ TOTAL DUE WITH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
CONTRACTOR INFORMATION:
CONT~CTORJfJ{/,&(J2iC -;n,/~( (l1J(}S/-.. .
ADDREss h 71q mojn:sf mA #242 Sofj nfZ97'-171?
CONTRACTOAREGISTR~TIONNO: J()qRf4.7 . " EXPlRATlONOATE:
PROJECT5UPERVISOR, \},"id V-...l'()cll/
PHONE, 7L/7-.54/3
1//Q/Zt1Io
PHONE,~"'~-~I'l/h
INSPECTIONS:
AN INSPECTION REQUEST SHOULD BE MADE PRIORTO POURING CONCRffi. AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE REAOYTO
POUR. CURB CUT AND SIDEWALK lNSPEcnONS CALL 72&376'3 (RECORDER] STATE YOUR DESIGINATED CITY JOB
NUMBEAJPERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REOUESTED, AND \rVHEN YOU WILL BE READY FOR INS PECTlON. CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 AM. WILL BE MADE THE '
SAME DAY,REOUESTS AFTER 7:00A.M. VV1LL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED .IN
AFTER EXCAVATIONS ARE MADE ANQ FORM WORK (S IN PLACE BUT PRfOR TO POURING CONCRETE.
YOU ARE REOUIREDTO CALL
IJHE LANE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
YV1 . .a HOURS BEFORE DIGGING
SIGNAT~-itJ / 11fMf'.:/
AlviOUNT RECEIVED: DATE PAID:
RECEIPT NO:
REC811ED BY:
and ~~r~~%7a~ld.1 ,ltC~~~ ~e~li~~l ~h~t ~~~v:II~~~u"~~~~~~h~le bCeDrJg;~I~da~~~~ :?l~ ~~b;~~~~~~hat all information herein is Jwe
the City of Spflnglleld, applicable eill Standard speCl~cations and OrawinQs, and the lam 01 Ihe Slale 01 Oregon perlaining 10 Ihe work desoibed herein. I funlier
cer1lfy IMI only conlraclors and empDyees who are In compliance wilh ORS 701,055 will be used . .
oolhlsprOjec:l. .
. .
The City may inspecl ,the work site described in Ihis permit at .any lime during a one year Period 10 n~g lhe receipl by Ihe- City 01 notice 01 ~~Ietion of the
descnbed work and speafy, al.lhe Diy's sole discretion any additional, restoration work reqUlre<:l 10 relurn the Sl1810 a standard accep'!able 10 lhe Ci . The
permltlee will be nolified in writing of any work required and will have lhlny days (30) Jrom the date of Ihe notice to complele the work. Work no! comp eled althe end
01 Ihe thlr1y days Will be perlormed by Ilie City and the coSIS will be billed 10 tlie permlltee. ,
Ilurttll;r agree 10 ensure lhat all required inspeclioos are requested at the proper time, that proj Eet address Is readablE from the
street, and Ihe approved sel 0/ plans ,will remain on the site al all timel! dUling construction. ~
Signalure
Date